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HRT: My Dad and his lab results, input highly appreciated

jay_dub

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Hey guys,

I dont know much about HRT. I told my Dad I would ask you guys to get some input about his lab results.

He's 55 years old:

Testosterone: 298
Testosterone, Free: 7
% Free Testosterone: 2.35

Now, I know anything under 300 is pretty damn low. I told him that before he went in to get tested. 2 years ago he went in and it was at 471... So hes dropped over 170 in a couple years. He just a normal guy, has never used anything, owned a construction company all his life until he messed up a couple disks in his back and now has a desk job.

My dad knows of my past use, so I've tried to educated him as much as possible. Hes very interested in getting a prescription.

What should he do from here? His doc told him 298 is a "normal" low. My dad didn't buy it though and told him he wanted to do something about this. He also mentioned gel, but I told my dad to stay away from that crap as well, and he told his doc he wasn't interested. He's going in again so we need to know what my dad should say.

Your guys' input would be awesome since I know so many of you have been in his shoes. Thanks in advance!
 

jay_dub

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Heres some more info that he just gave me, his cholesterol needs work, LDL specifically

Cholesterol: 254
Triglycerides: 121
HDL.: 55
LDL.: 175

Hes been taking 2000iu of D3 (softgels) everyday. I told him to try upping it to 6000iu.

Any other advice on this?
 

Emery

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Does he supplement with fish oil/flax oil? Red yeast rice?
If not, he should!

Hope that helps some...
 

PHIL HERNON

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Yes

Heres some more info that he just gave me, his cholesterol needs work, LDL specifically

Cholesterol: 254
Triglycerides: 121
HDL.: 55
LDL.: 175

Hes been taking 2000iu of D3 (softgels) everyday. I told him to try upping it to 6000iu.

Any other advice on this?
His LDL is way too high......use niacin and omega-3 fats............coQ10 also for extra protection
 

jay_dub

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Does he supplement with fish oil/flax oil? Red yeast rice?
If not, he should!

Hope that helps some...
I know hes used fish oil in the past but said the brand he was using gave him some bad fish breath. I'll tell him to start it up again.

His LDL is way too high......use niacin and omega-3 fats............coQ10 also for extra protection
Thanks Phil, can you tell me specifically how much Niacin and coQ10 you'd recommend for him? I've never used either... I probably should though.
 

jay_dub

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Thanks again Phil.

Now we have the cholesterol issue taken care of, how about the testosterone?
 

brutale

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Thanks again Phil.

Now we have the cholesterol issue taken care of, how about the testosterone?
Hi there. I'm 48 and have been on HRT for several years. The gains in quality of life - energy, memory, muscle, libido, etc. - are huge. I started with test within normal range, but not robust ... I think it was 350. So I had to talk that doctor into giving it a try with me, and I've never looked back.

Since then I've found a doc who specializes in HRT and who wanted to work on optimizing my hormones and health generally. PM me and I can give some names ... It makes a whole lot of sense to get a doc who knows HRT well.

Btw, lipids can improve dramatically when you bring test into the high normal range from low. That was my experience, and here are some studies:
The Effect of Testosterone Replacement on Endogenous Inflammatory Cytokines and Lipid Profiles in Hypogonadal Men -- Malkin et al. 89 (7): 3313 -- Journal of Clinical Endocrinology & Metabolism
Effect of testosterone replacement therapy on lipi... [Atherosclerosis. 1996] - PubMed result

(When you go to levels way above the normal range, the lipid story is different). Good luck!
 

brutale

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Thanks again Phil.

Now we have the cholesterol issue taken care of, how about the testosterone?
In terms of what to ask for, you have a lot of choices: IM testosterone, pellets, prescription gels, and compounded gels and creams.

Folks have their preferences, but unless the doc is an HRT specialist, you probably have a better shot of getting to "yes" if you ask for a gel (testim or androgel).

Some people don't do well on gels, but I do fine (and easily push my levels past the normal range w moderate amounts of testim). You might ask for 1tube a day to start.

A small amount (.5 mg 2x per week) of a-dex is usually part of the mix, along with a plan to deal with ball shrinkage (hcg for example). DHEA can be included.

Blood work needs to include psa, hematocrit, the usual hormones: test free and total, estradiol free and total,lh, fsh, etc.

Lots of good info out there. Google "John Crisler" for example.

Hope this helps.
 

kid1dakota

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Thanks again Phil.

Now we have the cholesterol issue taken care of, how about the testosterone?
Hey Jay dub,
I feel for your father I truly do as I have been where he is at.The problem is that he is feeling the effects of lowT but technically in normal range.I agree with you as anything below 300 is low but according to Labquest which most docs use it is like 242-800 for normal range.

I kept bugging my endo but until it got below "normal" it was like talking to the wall.They would have to explain to an ethics committee why they were prescribing a controlled substance to a pateint within range if anything ever went wrong.Most docs would rather lose the patient than their license.
You hear people on this very board saying "the doc works for you as you are a customer" "go to a new doctor" "demand the treatment you deserve" etc...Well its not exactly the way it works when you are requesting a controlled substances being reviewed by the DEA..

Your Dad could go to a HRT or longevity clinic and would receive a healthy dose for a healthy price and usually insurances aren't accepted,so cash only.

He could try some legal test boosters, which some would raise him to middle normal range.

I believe his test is on the decline,so get it checked twice a year and he will receive treatment at some point.He will probably be put on gel to start(pretty standard) and go from there.It is a long process,but one worthy of persistance.
Good luck :)
 

buck

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if you would include the lab ranges for the tests it would help to put things in perspective.
i had my sister-law start taking (no flush) niacin 500mg 2x a day and it dropped her cholesterol 46 points have had the same effect with others i have spoke to.
all the options are good as far as hrt. it just depends on your life style and preferences. gels raised my levels about 200 points to the mid range of normal, but my dht went to 3x the top of the range. just depends on the person. i prefer IM. and being at the top of the range, except for when i cycle. make sure he gets his E2 checked as well as it can make a huge difference on how he feels.
 

maldorf

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His LDL is way too high......use niacin and omega-3 fats............coQ10 also for extra protection
I agree 100%. My LDL is now running about 80. Anything over 100 is way high. I take niaspan, a prescription niacin and that helped my HDL. I do the Ubqiunol now which is supposed to be a more active form of CO Q10. All great supplements.
 

maldorf

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With my endo I told her that I had no interest at all in the gel and asked for the injectable. She had no issues with prescribing the IM shots. Did you father ask the doc about getting injectable?
 

Thebigone

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doesnt make sense levels dropped that fast in just a few years. Free test is much more accurate. Did he have his free test checked a few years ago. Labs make errors too and if he had any changes in diet and/or stress during the time of the test they could be off.
 

jay_dub

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Hi there. I'm 48 and have been on HRT for several years. The gains in quality of life - energy, memory, muscle, libido, etc. - are huge. I started with test within normal range, but not robust ... I think it was 350. So I had to talk that doctor into giving it a try with me, and I've never looked back.

Since then I've found a doc who specializes in HRT and who wanted to work on optimizing my hormones and health generally. PM me and I can give some names ... It makes a whole lot of sense to get a doc who knows HRT well.

Btw, lipids can improve dramatically when you bring test into the high normal range from low. That was my experience, and here are some studies:
The Effect of Testosterone Replacement on Endogenous Inflammatory Cytokines and Lipid Profiles in Hypogonadal Men -- Malkin et al. 89 (7): 3313 -- Journal of Clinical Endocrinology & Metabolism
Effect of testosterone replacement therapy on lipi... [Atherosclerosis. 1996] - PubMed result

(When you go to levels way above the normal range, the lipid story is different). Good luck!
In terms of what to ask for, you have a lot of choices: IM testosterone, pellets, prescription gels, and compounded gels and creams.

Folks have their preferences, but unless the doc is an HRT specialist, you probably have a better shot of getting to "yes" if you ask for a gel (testim or androgel).

Some people don't do well on gels, but I do fine (and easily push my levels past the normal range w moderate amounts of testim). You might ask for 1tube a day to start.

A small amount (.5 mg 2x per week) of a-dex is usually part of the mix, along with a plan to deal with ball shrinkage (hcg for example). DHEA can be included.

Blood work needs to include psa, hematocrit, the usual hormones: test free and total, estradiol free and total,lh, fsh, etc.

Lots of good info out there. Google "John Crisler" for example.

Hope this helps.
Thanks for all the info brutale, I will definitely send this my dads way. I'm really surprised you've had such luck with the gels. As you said, most people don't. You're one of the few that has actually said you like it! Is it the stuff medicap makes? My dad said the stuff the doctor recommended to him was made through medicap...

Hey Jay dub,
I feel for your father I truly do as I have been where he is at.The problem is that he is feeling the effects of lowT but technically in normal range.I agree with you as anything below 300 is low but according to Labquest which most docs use it is like 242-800 for normal range.

I kept bugging my endo but until it got below "normal" it was like talking to the wall.They would have to explain to an ethics committee why they were prescribing a controlled substance to a pateint within range if anything ever went wrong.Most docs would rather lose the patient than their license.
You hear people on this very board saying "the doc works for you as you are a customer" "go to a new doctor" "demand the treatment you deserve" etc...Well its not exactly the way it works when you are requesting a controlled substances being reviewed by the DEA..

Your Dad could go to a HRT or longevity clinic and would receive a healthy dose for a healthy price and usually insurances aren't accepted,so cash only.

He could try some legal test boosters, which some would raise him to middle normal range.

I believe his test is on the decline,so get it checked twice a year and he will receive treatment at some point.He will probably be put on gel to start(pretty standard) and go from there.It is a long process,but one worthy of persistance.
Good luck :)
Hey bro, does your insurance cover it since its through your doc and not an endo? I'll make sure and tell my dad to keep his head up and be persistent with this.

if you would include the lab ranges for the tests it would help to put things in perspective.
i had my sister-law start taking (no flush) niacin 500mg 2x a day and it dropped her cholesterol 46 points have had the same effect with others i have spoke to.
all the options are good as far as hrt. it just depends on your life style and preferences. gels raised my levels about 200 points to the mid range of normal, but my dht went to 3x the top of the range. just depends on the person. i prefer IM. and being at the top of the range, except for when i cycle. make sure he gets his E2 checked as well as it can make a huge difference on how he feels.
He went out and got some niacin yesterday (along with coq10) so he'll start that asap. And sounds like gels are more effective than I originally thought?

I agree 100%. My LDL is now running about 80. Anything over 100 is way high. I take niaspan, a prescription niacin and that helped my HDL. I do the Ubqiunol now which is supposed to be a more active form of CO Q10. All great supplements.
With my endo I told her that I had no interest at all in the gel and asked for the injectable. She had no issues with prescribing the IM shots. Did you father ask the doc about getting injectable?
He goes into the doctor this week. I told him to make sure and bring up the injectable. If you don't mind, how much is your prescription? My dad has decent insurance, I think its something like 10% co-pay.

doesnt make sense levels dropped that fast in just a few years. Free test is much more accurate. Did he have his free test checked a few years ago. Labs make errors too and if he had any changes in diet and/or stress during the time of the test they could be off.
I dunno about his free test from two years ago but I do believe his test could have dropped that fast in the past couple years. His energy has dropped and also has had a change in mood since then. He told me he "wants his energy back more than anything".

Sounds like getting older sucks!
 

kid1dakota

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Hey bro, does your insurance cover it since its through your doc and not an endo? I'll make sure and tell my dad to keep his head up and be persistent with this.
Actually I do get it through my endo as my levels eventually did get below or close enough to be considered out of range.

Funny thing about my insurance(cigna).They covered two tubes a day of testim gel retailing at walgreens for $600.00 per month,But wouldn't cover injectable cypionate that retails for $54.00 per month!!

But Walgreens has a prescription plan that costs $20.00 per year that covered the testosterone bringing down to $17.00 per month for cypionate.
 

maldorf

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cost with inrusance

I think mine runs about $35 or so for 3 months supply through the mail. My copay is 25%. The pins are free.
 

jay_dub

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So I guess my dad just decided to go with the Androgel. I kept telling him to request the shots instead but he never did. I think he just doesn't want to have to deal with going in to get a shot every two weeks.

He said hes gonna try it out and see how it goes and then evaluate from there. His insurance is decent so I think hes getting it for $30 a month or around there.

Regardless, thanks for all the info guys.
 

jay_dub

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I would go 1 gram niacin in the morning and again before bed......100 mg coQ10 with the niacin also......I use SLO Niacin
I just wanted to bump this thread.

After giving Phils advice to my dad and after he implemented this plan above for a few months he has lowered his total cholesterol 40 points!

I dont know exact numbers right now on LDL or HDL but my dad told me the doc was amazed how good his numbers were and wanted to know how the hell he did it. lol

Hes also taking androgel so I'm sure that helped some as well but regardless thanks again to everyone for responding and helping him get on the right track.
 

maldorf

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I just wanted to bump this thread.

After giving Phils advice to my dad and after he implemented this plan above for a few months he has lowered his total cholesterol 40 points!

I dont know exact numbers right now on LDL or HDL but my dad told me the doc was amazed how good his numbers were and wanted to know how the hell he did it. lol

Hes also taking androgel so I'm sure that helped some as well but regardless thanks again to everyone for responding and helping him get on the right track.
Sounds good. DO you know what his total test is now while on the gel? How does he like it?

BTW. if he wants to do injections the doc can write him a script for pins so he can do injections on his own at home. This is if he would like to try that method instead of gel.
 

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